Difference between revisions of "Epidermoid cyst of the testis"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Epidermoid cyst of testis -- low mag.jpg
| Width      =
| Caption    = Epidermoid cyst of testis. [[H&E stain]]. (WC)
| Synonyms  =
| Micro      = unilocular cyst lined by squamous epithelium without significant nuclear atypia, no [[GCNIS]] (ITGCN)
| Subtypes  =
| LMDDx      = [[teratoma]], [[mixed germ cell tumour]], [[immature teratoma]], [[dermoid cyst]] of testis (subtype of teratoma)
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = unilocular cyst containing keratineous material with a laminated appearance
| Grossing  = [[orchiectomy grossing]]
| Site      = [[testis]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      = testicular mass
| Symptoms  = typically asymptomatic
| Prevalence = rare (1-2% of testicular masses)
| Bloodwork  = normal (beta-hCG, AFP, LDH)
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = other testicular mass - [[germ cell tumours]], abscess
| Tx        = excision to exclude a malignant tumour/treat symptoms
}}
'''Epidermoid cyst of the testis''' is a rare benign lesion of the [[testis]].  It is important to differentiate it from a testicular [[teratoma]].
'''Epidermoid cyst of the testis''' is a rare benign lesion of the [[testis]].  It is important to differentiate it from a testicular [[teratoma]].


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*Rare.
*Rare.
*Benign.
*Benign.
*1-2% of testicular tumours.<ref name=pmid15486244>{{Cite journal  | last1 = Loya | first1 = AG. | last2 = Said | first2 = JW. | last3 = Grant | first3 = EG. | title = Epidermoid cyst of the testis: radiologic-pathologic correlation. | journal = Radiographics | volume = 24 Suppl 1 | issue =  | pages = S243-6 | month = Oct | year = 2004 | doi = 10.1148/rg.24si035223 | PMID = 15486244 }}</ref>
*Typical age: teens to thirties (range: 3-77).<ref name=pmid15486244/>


Clinical:
*Asymptomatic mass (typical).<ref name=pmid15486244/>
==Gross==
==Gross==
Features:<ref name=pmid22458906>{{Cite journal  | last1 = Ye | first1 = H. | last2 = Ulbright | first2 = TM. | title = Difficult differential diagnoses in testicular pathology. | journal = Arch Pathol Lab Med | volume = 136 | issue = 4 | pages = 435-46 | month = Apr | year = 2012 | doi = 10.5858/arpa.2011-0475-RA | PMID = 22458906 }}</ref>
Features:<ref name=pmid22458906>{{Cite journal  | last1 = Ye | first1 = H. | last2 = Ulbright | first2 = TM. | title = Difficult differential diagnoses in testicular pathology. | journal = Arch Pathol Lab Med | volume = 136 | issue = 4 | pages = 435-46 | month = Apr | year = 2012 | doi = 10.5858/arpa.2011-0475-RA | PMID = 22458906 }}</ref>
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==Microscopic==
==Microscopic==
Features:<ref name=pmid22458906/>
Features:<ref name=pmid22458906/>
*Cyst lined by squamous epithelium.
*Cyst lined by squamous epithelium without significant [[nuclear atypia]].
*No significant [[nuclear atypia]].
*'''No''' adnexal structures.
*'''No''' adnexal structures.
*'''No''' [[intratubular germ cell neoplasia]] in the adjacent seminiferous tubules.
*'''No''' [[germ cell neoplasia in situ]] (GCNIS) in the adjacent seminiferous tubules.
*'''No''' nuclear atypia.
*'''No''' nuclear atypia.
Notes:
*Surround testis usually within normal limits.
*Granulomas may be seen in the context of cyst rupture.


DDx:
DDx:
*[[Dermoid cyst]] - adnexal structures, e.g. sweat glands, hair follicules.
*[[Dermoid cyst]] - adnexal structures, e.g. sweat glands, hair follicules.
*[[Teratoma]] - nuclear atypia, multilocular, mesenchyme elements, ITGCN present.  
*[[Teratoma]] - nuclear atypia, multilocular, mesenchymal elements.  
*[[Mixed germ cell tumour]].
*[[Mixed germ cell tumour]].
===Images===
<gallery>
Image: Epidermoid cyst of testis -- very low mag.jpg | ECT - very low mag.
Image: Epidermoid cyst of testis -- low mag.jpg | ECT - low mag.
Image: Epidermoid cyst of testis -- intermed mag.jpg | ECT - intermed. mag.
Image: Epidermoid cyst of testis -- high mag.jpg | ECT - high mag.
</gallery>


==See also==
==See also==
*[[Testis]].
*[[Testis]].
*[[Epidermal inclusion cyst]].


==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Testis]]
[[Category:Testis]]

Latest revision as of 23:42, 15 March 2016

Epidermoid cyst of the testis
Diagnosis in short

Epidermoid cyst of testis. H&E stain. (WC)

LM unilocular cyst lined by squamous epithelium without significant nuclear atypia, no GCNIS (ITGCN)
LM DDx teratoma, mixed germ cell tumour, immature teratoma, dermoid cyst of testis (subtype of teratoma)
Gross unilocular cyst containing keratineous material with a laminated appearance
Grossing notes orchiectomy grossing
Site testis

Signs testicular mass
Symptoms typically asymptomatic
Prevalence rare (1-2% of testicular masses)
Blood work normal (beta-hCG, AFP, LDH)
Prognosis benign
Clin. DDx other testicular mass - germ cell tumours, abscess
Treatment excision to exclude a malignant tumour/treat symptoms

Epidermoid cyst of the testis is a rare benign lesion of the testis. It is important to differentiate it from a testicular teratoma.

General

  • Rare.
  • Benign.
  • 1-2% of testicular tumours.[1]
  • Typical age: teens to thirties (range: 3-77).[1]

Clinical:

  • Asymptomatic mass (typical).[1]

Gross

Features:[2]

  • Unilocular cyst containing keratineous material with a laminated appearance.

Notes:

  • Teratomas are usually multilocular.
  • Presence of hair suggests a dermoid cyst.

Microscopic

Features:[2]

Notes:

  • Surround testis usually within normal limits.
  • Granulomas may be seen in the context of cyst rupture.

DDx:

Images

See also

References

  1. 1.0 1.1 1.2 Loya, AG.; Said, JW.; Grant, EG. (Oct 2004). "Epidermoid cyst of the testis: radiologic-pathologic correlation.". Radiographics 24 Suppl 1: S243-6. doi:10.1148/rg.24si035223. PMID 15486244.
  2. 2.0 2.1 Ye, H.; Ulbright, TM. (Apr 2012). "Difficult differential diagnoses in testicular pathology.". Arch Pathol Lab Med 136 (4): 435-46. doi:10.5858/arpa.2011-0475-RA. PMID 22458906.